title: Imaging modalities for the early diagnosis of acute aortic syndrome.
abstract: The term acute aortic syndrome (AAS) incorporates aortic dissection, intramural haematoma, and penetrating atherosclerotic ulcer. The common feature of these entities is disruption of the medial layer of the aortic wall. Owing to the life-threatening nature of these conditions, prompt and accurate diagnosis is of paramount importance--misdiagnosis can be fatal. The noninvasive imaging techniques that have a fundamental role in the diagnosis and management of patients with AAS include CT, MRI, transoesophageal echocardiography (TEE), and transthoracic echocardiography (TTE). CT is the most-commonly used imaging modality owing to its wide availability, accuracy, and large field of view. CT plus TTE is the best combination for diagnosing AAS and its complications, and allows important morphological and dynamic aspects of AAS to be assessed and appropriately managed. Ideally, TEE should be performed immediately before surgery or endovascular treatment, in the operating theatre and under general anaesthesia. In stable patients with an uncertain diagnosis of intramural haematoma despite high clinical suspicion, MRI is the technique of choice to make a definitive diagnosis. Imaging techniques have an important role in the primary diagnosis, treatment strategy, and risk stratification of patients with AAS.
authors.affiliation: Department of Cardiology, Hospital Vall d'Hebron, P° Vall d'Hebron 119, 08035 Barcelona, Spain. aevangel@vhebron.net
authors.forename: Artur
authors.initials: A
authors.lastname: Evangelista
authors.forename: Amelia
authors.initials: A
authors.lastname: Carro
authors.forename: Sergio
authors.initials: S
authors.lastname: Moral
authors.forename: Gisela
authors.initials: G
authors.lastname: Teixido-Tura
authors.forename: José F
authors.initials: JF
authors.lastname: Rodríguez-Palomares
authors.forename: Hug
authors.initials: H
authors.lastname: Cuéllar
authors.forename: David
authors.initials: D
authors.lastname: García-Dorado
mesh_terms: D000208:Acute Disease; D001018:Aortic Diseases / Q000175:diagnosis*; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D064847:Multimodal Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D013577:Syndrome